Abdominal and pelvic floor muscle activation patterns during coughing in women with and without stress urinary incontinence.

摘要

To better understand the mechanisms underlying continence, this thesis describes the abdominal and pelvic floor muscle (PFM) activation patterns used during coughing in both continent and incontinent women, by (i) describing the sequence of abdominal and PFM activation during coughing, (ii) evaluating the effect of incontinence status and position (supine and standing) on these patterns, and (iii) comparing the activation amplitude of abdominal and PFM during coughing between groups and positions.;It was concluded that muscle activation patterns are definable for both groups of women tested during coughing and these patterns are affected by position. During coughing, abdominal and PFM activation amplitudes are different between the two groups.;Control subjects in standing showed earlier activation timing for the right PFM and a tendency for external obliques (EO) to be activated prior to the rise in intravaginal pressure. In supine the control subjects' upper vaginal pressure rose prior to the activation of any abdominal or PFM. For the stress urinary incontinence (SUI) group when in supine, rectus abdominis (RA) and internal obliques (IO) were found to be activated only after the rise in lower intravaginal pressure. Conversely, in standing the SUI group showed no significant difference in onset times between any of the muscles relative to the rise in lower intravaginal pressure. During coughing, the control group generated higher electromyography (EMG) amplitudes and pressures for all the muscles and pressures in both positions.